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The economic-financial sustainability of the PROESF in the States of Amapá, Maranhão, Pará and Tocantins

As part of the baseline studies of the PROESF (Project for the Expansion and Consolidation of Family Health), this article studies the funding of the PSF (Program for Family Health) from the viewpoint of its financial sustainability. It approaches aspects related to the construction of measures and indicators for sustainability based on a recent Brazilian political experience of differentiating the financial incentives given by the Unified Health System (SUS) through the PROESF to municipalities with more than 100 thousand inhabitants. The suggested inclusion of indicators only allows for defining the long-term coherence of the planned actions from the financial standpoint. This approach does not exclude the need for a critical review of the criteria currently used by the incentive policy of the PSF and its differentiation between municipalities, which is not exclusively based on their size. The differences in the situations of the municipalities with respect to sustainability pointed out in this study draw attention to the limits and limitations of applying alike policies to unalike situations, with foreseeable consequences of maintaining or worsening inequity.

Primary health care; PSF; Financial incentives; Financial sustainability


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